Treating a Stunt Woman’s Wrist “Complex” with a “Basic” Wrist Program The MovEvolution Treatment Pyramid
History:
Toni, a 30-year-old professional stunt woman, has a 3-year history of right wrist trauma and pain. She came to us after numerous treatments, injections, braces, splints, and diagnostics.
Problems:
We asked Toni to list her current problems:
-Right shoulder blade: Feels like there’s a “bubble” that seizes up my entire right side into my neck and down my arm when I breathe. My boyfriend took a massage gun to it, and it hasn’t helped. The pain causes headaches. This has been an on-and-off problem
-Left knee: discovered there’s misalignment. There’s a pain in that shin through the ankle when I run, which I believe stems from the knee
-Left bone under big toe: This was a fracture that I think never healed right. Can feel it if I jump or run a little bit. The solutions are insoles or a cushy cut-out place there that I’ve never used.
-Right hip: unable to bring the leg up straight all the way. Feels like there’s a blockage in the thigh. Nothing painful, just not full motion
-Right wrist: everything
Goals:
Toni also wrote out her functional goals:
-Wrist mobility and strength: hold and swing weapons. Do a push-up/handstand. Swing and grab a bar out of mid-air. All in all, trusting my wrists
-Core strength: I feel this is a base for anything I do and my core just isn’t strong. This could help with handstands, swinging weapons, and falling
-Jumping far/high: Getting the fast twitch muscles back, which helps with speed of performance
-Shoulder mobility and strength: Similar to wrists, being able to trust my shoulders not to collapse. Would like to be able to do a handstand. Box and throw punches without the impact causing pain
-Leg flexibility: Realistically, I’d like all-around flexibility, but the leg is the biggest one. But flexibility with strength is the goal. For kicks!
Yes, this is a lot more I do. Am I overwhelmed? No, because I follow a logical treatment system. Following our MovEvolution Treatment Pyramid ensures that I don’t miss any steps in Toni’s care and will keep us both on the same page regarding her treatment protocols and progression.
This is Toni’s 4-6 week prescription:
Education:
The more she knows, the better she grows. This is a great opportunity to address Toni’s prognosis, plan of care, pain maintenance, and basic upper extremity anatomy and physiology.
Pain:
One size does not fit all. We need to give Toni options so she may choose the appropriate tool at the appropriate time. For Toni, we discuss and describe:
- Ice vs heat
- Gua sha scraping (or instrument-assisted soft tissue mobilization) with light loading
- Voodoo flossing
- Taping
- Massage
- Light isometrics
- Bucket of rice (for finger and wrist active range of motion)
Alignment:
Why this before mobility and strength? Like any other joint, establishing proper alignment not only protects the joint but puts Toni’s muscles in better “power positions”, where they can exert more force with less effort. Skipping this step may reinforce habitual poor posture and muscle imbalance.
With Toni, we emphasize improved postural awareness of both her wrist (especially when loading) and her rounded scapulae.
Mobility:
Gaining more wrist real estate will be a slow and gradual process, guided by pain and where we are in the healing process.
Toni’s recent MRI came back negative, and we are well beyond the acute phase of her injury.
Wrist
We’re going to mix it up with Toni to introduce a gradual program in mobility intensity.
Passive Stretching
Hold 30 seconds 3 sets
Use the non-injured hand to gently stretch the wrist into end range (all directions)
Contract/Relax
Contract 5 seconds, 5 sets
Gently stretch to end range. Gently resist the movement. Repeat.
Active Stretching:
1 minute x 5 sets
No instructions are needed. Use the muscle of the injured wrist to travel around the world, exploring new territory. Add a little overpressure with the help of the other hand if tolerated. Pain should not creep past 2 out of 10!
Chronic arm and shoulder pain can lead to neck and spine misalignment. We recommend the Bretzel as part of Tony’s home program for enhanced spinal rotation. Perform it 10 times on each side.
Wrist injuries are tricky. With Toni, we keep the rehab and return-to-play protocols simple. We start with a solid foundation of education and pain modulations and slowly start to challenge the soft tissue and joint ranges of motion and load tolerance in well-aligned positions.
Tune in next newsletter to see Toni’s progress and treatment plan updates.
Wrist rehab tip 💡
Dealing with an injured wrist, arm, or shoulder? When it’s time to find a rehab professional, choose someone who truly gets your sport! Look for a specialist who incorporates “sports-specific” training into your treatment plans, ensuring your recovery is both effective and efficient. No, your path to getting back in the game starts here!
